Dr. Khanna's Appointment
Call 9860641998 or Fill below details for Exclusive appointment of Dr. Khanna
Patients Name *
Please provide full name of patient
Patients Contact Number *
Confirmation of appointment will be given on this number
Clinic Location *
Please select location of Clinic as per your convenience
Date of Appointment *
Please select date and year carefully
Time of Appointment *
Time Should be Between, Mon-Sat :: 9:00 am – 10:30 pm or Sunday :: 9:00 am – 5:00 pm
Purpose for Appointment *
Please select purpose carefully
Visiting for First time or Re-visiting? *
Please confirm if you are visiting for First time or are existing patient
Referred by *
how did you find us
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.